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DanlB

I'd posted a bit ago about my wife beginning the Starting Strength program with me, after having watched me fart around with it for a week. At the time, we didn't think she'd be able to squat with one knee having been replaced last year and the other needing replacement. Tom C replied to that post, and I've been meaning to say thanks, and to write a follow-up. But life has its own ideas, and I'm just getting to it.

So we saw her doc recently, and he cleared her to squat: she can do whatever she wants under the bar, with pain as the guide as to what's too much. We were pleasantly surprised at that news, and very happy about it.

Her overall response to barbell training has been fantastic, especially in its apparent effect on her multiple sclerosis symptoms (probably a good subject for a post to the testimonials forum). We still have a question regarding the squat, though.

She has full range of motion in the operated knee, though that is reduced when bearing weight. Her first squat workout, we followed the sequence in the recently posted video in which Beau's coaches Dan in the squat as a beginner in his 70s. When she got the bar on her shoulder, we found she really couldn't get below a half squat without pain -- in the operated knee, probably due to scar tissue. She's had surprisingly little pain in the other knee.

So we have treated this as a rehab case, working on range of motion in the squat, without the bar. We had her doing squats onto and off of a stack of practice plates, lowering the height a bit at a time. Today, we abandoned the stack and had her start practicing the squat as in the book. She is able to reach parallel regularly, but there is still some pain and stiffness driving a few form errors we're working on.

So right now, we're treating ROM as the variable in her progression for the squat. (Her other lifts are coming along nicely, though if she pushes too hard in her squat work, she can't always finish the deadlift work set due to knee pain.) Our thinking is that we'd like to see her get full depth in the squat without pain or loss of form before we add weight. She's made good progress in the last two weeks, and we only wish we'd started this rehab business a long time ago (just as I'm wishing I'd started lifting 20 years ago....)

Now we'd like to know whether our rehab approach to working her into the squat -- getting solid on ROM first before introducing weight -- makes sense to someone with actual experience and credentials in coaching this program?

Tom Campitelli

Treating ROM as the variable is exactly correct. Well done.

The squat may not be completely pain free at this point. She had a knee replacement and things may hurt as she works into new ranges. The keys will be how distracting that pain is and whether the pain gets worse. Obviously, neither of us can feel what she is feeling, but that knee may hurt a little for a while.

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ianperez7

If I am unable to assume a proper deadlift starting position, does that mean that the tightness is ok or are there other factors to consider? I have been wearing my belt just barely snug, but recently tried 1 hole tighter, which made it fairly tight, but I'm not sure if it's a problem. I recorded a set with the tighter belt, and it looked ok, but I really felt a lot of pressure in my abs during the lift and I felt a little queasy after 1 or 2 of the reps during a very heavy 4x5 with ascending weight, but the queasy feeling passed very quickly. Does that sound like a problem?

Mark Rippetoe

If you have to stretch your abs up to get the pin in the hole, it's too tight because you won't get squeezed back down into position. The belt will literally keep you from making an effective ab contraction. But this may not be the problem with your deadlifts; sometimes a thick belt interferes with deadlift position since you have to get into the start position without the help of the loaded eccentric contraction that carries you into the bottom of the squat. A thinner belt helps my deadlift start.